FORMULIR PENDAFTARAN ANGGOTA GERAKAN PRAMUKA

GUGUS DEPAN 18.081 - 18.082

1. Nama Lengkap : ..........................................................................

2. Tempat dan Tanggal Lahir : ..........................................................................

3. Agama : ..........................................................................

4. Nama Orang Tua/Wali : ..........................................................................

5. Pekerjaan Orang Tua/Wali : ..........................................................................

6. Alamat Tempat Tingal : ..........................................................................

............................................................................

............................................................................

7. Anak ke : ...........jumlah saudara : ..................................

Pa......orang, pi ..............orang.

8. Golongan Darah : .........................................................................

9. Sekolah : .........................................................................

10. Bakat dan hobby : .........................................................................

11. Hal – hal yang perlu diperhatikan

(kebiasaan, kesehatan,bahasa yang dikuasai dan lain – lain)

.........................................................................................................................

.........................................................................................................................

.........................................................................................................................

12.Lain – lain : ........................................................................

.........................................................................

Sumedang, .......................2020.

_____________________________

Orang Tua / Wali Siswa

 DAFTAR INDUK ANGGOTA GERAKAN PRAMUKA GUGUS DEPAN
DAFTAR INDUK GERAKAN PRAMUKA
GUGUS DEPAN : ....................................................................
NO NTA NAMA AGAMA NAMA PEKERJAAN ALAMAT TGL KET
LENGKAP/TTL ORTU/WALI ORTU/WALI RUMAH MASUK
1

10

11

12

13

14

15

16

17

18

19

20

.............................,........................20......
PEMBINA GUDEP

(.....................................................)
 ADMINISTRASI KEUANGAN GUGUS DEPAN
PENERIMAAN DAN PENGELUARAN UANG GUGUS DEPAN

BULAN : ...............................................
TGL. URAIAN NO. BUKTI PENERIMAA PENGLUARAN KET.
N RP. RP.

.......................................,..............20.......

PEMBINA GUGUS DEPAN

(.........................................................)
 DAFTAR INVENTARIS GUGUS DEPAN

NO. NAMA MERK/TYPE KODE JUMLAH HARGA CARA/TGL KOND./

BARANG BARANG BARANG PENGADAAN KET.

........................,..................20....
PEMBINA GUGUS DEPAN
(................................................)
 BUKU TAMU GUGUS DEPAN 20.047 – 20.048

NO. HARI/TANGGAL NAMA ALAMAT JABATA TUJUAN SARAN/ PARAF

LENGKAP N PESAN
 LAPORAN SEMESTER DATA DAN KEGIATAN
GUGUS DEPAN 18.081 – 18.082
I. UMUM
1. Gugus Depan 18.081 – 18.082
2. Alamat .................................... telepon .................................................
3. Tempat Berlatih ....................................................................................
II. KEANGGOTAAN
1. Orang Dewasa
a. Pembina Gugus Depan :.........................Orang.
b. Pembina Satuan :........................Orang.
c. Pembantu Pembina :........................Orang.
2. Peserta Didik
a. Penggalang Ramu : ......................................Orang.
b. Penggalang Rakit : ......................................Orang.
c. Penggalang Terap : ......................................Orang.
Jumlah keseluruhan pembina dan peserta didik ..................Orang.
3. Laporan tingkatan TKK

TKK WAJIB : ............................................................

...........................................................
TKK PILIHAN : ............................................................
............................................................
............................................................

III. KEGIATAN
1. Gugus Depan
: ......................................................................................................................
....................................................................................................................................
....................................................................................................................................
......................................................................................................................
2. Pasukan Penggalang :
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
........................................................................................................
IV. KEUANGAN
1. Pemasukan ......................................................Rp
2. Pengeluaran .................................................... Rp ____________________
Saldo .............................................................. Rp

( Bukti Fisik dilampirkan )

.................................,......................20.....
Pembina Gugus Depan 18.081 -18.082

( .................................................)
 CATATAN PERISTIWA PENTING
(LOG BOOK )

HARI/TGL/WAKTU PERISTIWA,ILLUSTRASI,GAMBAR,TEMPELAN,GUNTINGAN BERITA

 CATATAN PRIBADI ANGGOTA GERAKAN PRAMUKA
GUGUS DEPAN 18.081 – 18.082 PANGKALAN SMPN 2 SUMEDANG

1. Nama Lengkap : .......................................................................................

2. Tempat dan tanggal lahir : .......................................................................................
3. Agama : .......................................................................................
4. Masuk anggota tgl. : .......................................................................................
5. Sifat baik yang perlu dikembangkan
: .........................................................................................
.........................................................................................
6. Sifat yang tidak baik yang perlu dikurangi
: ..............................................................................................
....................................................................................
7. Kepemimpinan yang pernah dialami
: ..............................................................................................
....................................................................................
8. Peristiwa – peristiwa penting selama menjadi anggota Pramuka :
................................................................................................
................................................................................................
...........................................................................
9. Observasi terhadap pribadi anggota : ( A,B+,B,C+,C ).
a. Kecerdasan :.....................................................................................
b. Gotong Royong :.....................................................................................
c. Disiplin :.....................................................................................
d. Kegembiraan :.....................................................................................
e. Penolong :.....................................................................................
f. Loyalitas :.....................................................................................
g. Kejujuran :.....................................................................................
h. Inisiatif :.....................................................................................
i. Kepribadian :.....................................................................................
j. Kreatifitas :.....................................................................................
k. Pengabdian :.....................................................................................

Tanjungkerta, ...............................20........

Pembina Gudep 18.081 – 18.082

( ..................................................)

PROGRAM KERJA PASUKAN PENGGALANG GUDEP 18.081 – 18.082

 BULAN ............................................S/D .........................................20.......
NO JENIS KEGIATAN BULAN JML KET.
. PENGGALANG
1. Penerimaan masa tamu

2. Latihan SKU penggalang

ramu

3. Ujian SKU penggalang ramu

4. Pelantikan penggalang
Ramu

5. Latihan SKU penggalang

rakit

6. Ujian SKU panggalang rakit

7. Kenaikan tingkat menjadi

penggalang rakit

8. Latihan SKU penggalang

terap

9. Ujian SKU penggalang terap

10. Kenaiakan tingkat menjadi

penggalang terap

11. Kegiatan lainnya